A New Model for Environmental Assessment and Exposure Reduction

Abstract

Environmental assessment and exposure reduction are a set of diagnostic and treatment techniques that work in tandem with the traditional medical approach by reducing a patient’s exposure to adverse environmental conditions as part of medical care. Assessment involves identifying the specific exposures to which a patient is sensitive and locating the corresponding contaminants in the patient’s environment. This provides a more complete diagnostic evaluation of a patient’s problem than could be obtained merely by examining the patient alone. Exposure reduction involves reducing the identified triggers to levels that are below thresholds that are associated with increased risk of sensitization and disease morbidity. Assessment of an environment for contaminants focuses on a chain of factors that include contaminant sources such as cockroaches, rodents, dust mites and fungi that excrete contaminants into an environment, facilitative factors such as moisture, food, water and shelter that help sources to thrive, and reservoirs where contaminants can accumulate prior to subsequent transport to occupants. By using this model to guide environmental assessments and their corresponding interventions, the root cause of health problems can be addressed, leading to improved quality of life for patients and reduced need for chronic medications.

Food, health, and complexity: towards a conceptual understanding to guide collaborative public health action

“…Table 2 shows the 35 drivers shared between only two of the five population health issues [ 75 – 149 ]. Figure 2 depicts the 11 drivers common to three issues (climate [ 75 , 124 , 138 , 145 , 146 , 149 ]; consumer food choice and eating behaviours [ 76 , 86 , 91 , 97 , 109 , 112 , 115 , 117 – 119 , 123 – 126 , 129 , 130 , 139 , 141 , 142 , 150 , 151 ]; individual food intake [ 76 , 87 , 97 , 101 , 114 , 116 , 120 , 122 , 124 , 129 – 131 , 139 , 141 , 143 , 151 , 152 ]; food availability [ 76 , 100 , 101 , 104 , 112 , 113 , 117 , 123 – 125 , 128 – 130 , 136 , 138 , 146 ]; suppressed/susceptible immune system [ 97 , 124 , 136 , 146 ]; socioeconomic status [ 75 , 76 , 93 , 98 , 100 , 117 ,…”

Procedures to Assist Health Care Providers to Determine When Home Assessments for Potential Mold Exposure Are Warranted

“…The first step is for clinicians to consider asking key questions to determine whether the common facilitative factors associated with environmental exposure to moisture and fungal growth may be present 20 Part A (shown in Figure 1) includes five (5) questions for the clinician (or designate) to administer to a patient with confirmed symptoms that are consistent with an increased likelihood of exposure to fungal growth. They are not specific to fungal exposure, so dust mites and other relevant allergens should also be considered 13–15 .…”

Environmental Health Education for Teachers: Results of Pre- and Post-surveys from a Pilot Study Addressing Chemical Use Reduction and Integrated Pest Management in Homes

“…Shared messages and education on IPM and CR inadults and children in the United States, respectively [7]. It is imperative for all households to understand and control adverse exposures in the home that contribute to asthma and other respiratory illnesses [8][9][10][11][12] and to maintain a clean home free of pests [13,14]. In the 2011 United States Housing Survey, it was estimated that over 13 million housing units across the nation (out of 132 million) had seen signs of cockroaches in the last 12 months.…”